Emergency percutaneous revascularization followed by mitral transcatheter edge-to-edge repair with MitraClip successfully reduced severe mitral regurgitation to mild in a patient with papillary muscle rupture.
Case Report (n=1)
Is fully percutaneous emergency management with coronary angioplasty and MitraClip feasible in a patient with acute myocardial infarction complicated by papillary muscle rupture?
Emergency fully percutaneous management with coronary angioplasty and MitraClip is feasible as a bail-out option for acute MI complicated by papillary muscle rupture in patients with prohibitive surgical risk.
Abstract Background papillary muscle rupture (PMR) in a rare and life-threatening complication of a myocardial infarction (MI). In our case we describe a complete percutaneous emergency management of this complication with coronary angioplasty followed to successful MitraClip repair. Case Summary we report a case of a 62-years-old man with MI and severe mitral regurgitation. We performed percutaneous revascularization and intra-aortic balloon pump was placed (IABP). After a transthoracic and transesophageal echo evaluation a PMR was diagnosed. Due to intractable pulmonary oedema, we proceed to emergency mitral edge-to-edge repair with two MitraClip just two hours later. Mitral regurgitation was reduced to mild and patient was estubated. Conclusion this case reports a completely percutaneous management of a MI complicated by PMR in prohibitive surgical risk patient. Emergency treatment of MI and PMR with coronary angioplasty and MitraClip is feasible and could be a bail-out option in high surgical risk patients.
Pennacchi et al. (Mon,) conducted a case report in Acute myocardial infarction complicated by papillary muscle rupture and severe mitral regurgitation (n=1). Percutaneous revascularization and mitral transcatheter edge-to-edge repair (MitraClip) was evaluated on Reduction of mitral regurgitation and clinical stabilization. Emergency percutaneous revascularization followed by mitral transcatheter edge-to-edge repair with MitraClip successfully reduced severe mitral regurgitation to mild in a patient with papillary muscle rupture.